Topic Contents

Open-Joint Arthroplasty for Temporomandibular Disorders

Surgery Overview

Open-joint arthroplasty is surgery to repair, reposition, replace,
or remove parts in a joint. When used to treat
temporomandibular disorder (TMD), this usually
involves the articular disc that cushions the jaw joint.

During open-joint arthroplasty of the jaw, an incision is made in
the skin to expose the jaw joint. The surgeon may repair, reposition, or
replace the disc with your own tissue or an artificial disc. Scar tissue or
bony growths in the jaw joint can also be removed.

Open-joint arthroplasty is done under
general anesthesia. You can normally expect to go home
the same day.

When jaw joint movement cannot be regained because the disc has
changed too much or the joint has broken down, the surgeon may need to remove
the disc (discectomy) and replace it with an artificial disc.

What To Expect After Surgery

After surgery, medicines are prescribed to relieve pain and reduce
swelling.

You can start physical therapy within 48 hours to maintain movement
and prevent scar tissue from forming.

You may be given a mouthpiece (splint) to wear while rehabilitating
your jaw.

Why It Is Done

Open-joint arthroplasty is used when:

There are bony growths within the jaw joint.
Such growths are hard to reach with
arthroscopic methods.

Complications from a
previous surgery occur, such as the failure of an artificial joint
replacement.

The joint is fused together by bony growth
(ankylosis).

The joint is not accessible with arthroscopic
surgery.

How Well It Works

Disc repositioning surgery can relieve pain and improve jaw function. This surgery has good results 80% to 95% of the time.1

Risks

Possible complications include:

Loss of jaw movement. Everyone has some
decrease in jaw mobility after surgery, because the jaw heals with scar tissue,
which is harder and tighter than normal tissue. But jaw exercises will help jaw
movement.

Adverse reaction to the materials in an artificial disc.
The risk of tissue rejection is higher if artificial materials, rather than
your own tissue, are used.

What To Think About

When possible, a nonsurgical approach is preferred over surgery,
because:

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